What to know about surgical site infections

The course of a surgical site infection usually has two parts. The first is short and intense: the incision becomes painful, red and swollen, often some days after you thought the hard part was over, and the surgical team steps in. The second part is slower. Once the infection is controlled, an incision that was opened has to fill with new tissue from its base upward, and that work goes on well after the last antibiotic dose. Drainage normally lessens, the wound gets shallower and the edges draw inward. Progress is not always even. A wound can stall, or a pocket can form under skin that looks closed. Some wounds are stitched shut later by the surgeon once they are clean.

What an assessment covers

The wound is only part of the assessment. The treating clinician also asks about pain, appetite, bowel changes since the antibiotic began, and how well you are moving around. Temperature and pulse are noted. If the incision is on the abdomen, the clinician considers strain from coughing or lifting. If it is on a leg, swelling and circulation get attention. The clinician then decides who should hear about what, such as the surgeon for a suspected deep pocket or the primary care clinician for poor eating and drinking. The plan names what will be checked at each visit and what result would prompt a call.

Arranging this care in Webster Groves

Many homes in Webster Groves are older single-family houses with the bedroom and full bath upstairs, which matters after surgery. A person with an infected abdominal or hip incision may be living on the first floor for a while, and the dressing supplies, good light and a firm chair need to be there too. Long-time residents here often recover with a spouse of similar age as the main helper. If packing or changing a draining dressing is too much for that person, Gateway can ask the treating clinician about bringing in home health.

Large frame and brick houses are common in Webster Groves, often with the bedrooms and the only full bathroom upstairs. There are also smaller bungalows, apartments and condominiums near the business districts, and senior living that includes independent apartments, assisted living and skilled nursing care in and around the city. Gateway arranges visits with partner clinicians in each of these settings. In a private home, the clinician can see where the patient actually sleeps, sits and bathes, which often matters for a wound. In a facility, we coordinate timing and orders with the staff.

When care happens at home

Recovering from an operation at home already means lifting limits, less driving and a body that tires quickly. An infection adds surgeon rechecks, sometimes lab work, and a wound that has to stay dressed. Bringing wound visits to the house removes some of those trips. For appointments that still have to happen in person, such as a recheck with the surgeon, Gateway can help with transportation arrangements and send the latest wound notes to the office beforehand. If home health is already coming for therapy or nursing, we coordinate so the wound orders reach that agency and the two schedules do not collide.

Care in skilled nursing and assisted living

Many people who develop a surgical site infection are already in a skilled nursing or rehabilitation center, recovering from a joint replacement, a hip repair or abdominal surgery. There, facility nurses change the dressing and take vital signs, and the attending physician oversees medical care. The treating wound clinician adds a focused wound exam at each visit, writes or recommends orders according to the facility’s process, and talks with the nurses who see the incision every day. Gateway arranges those visits with the facility and routes the clinician’s notes to the surgeon, so the three teams are reading the same record.

Changes to report

Between visits, the dressing and the skin around it tell you a lot. Contact the treating clinician or the surgeon’s office if you notice:

  • Redness or darkening of the skin that extends past where it was yesterday
  • Drainage that soaks through sooner than it used to
  • Fluid that turns thick, cloudy or foul smelling
  • Skin edges that pull farther apart
  • A firm, tender or soft, swollen lump beside the incision

Call 911 for heavy bleeding that does not stop with firm pressure, if tissue from inside the body bulges through an open abdominal wound, or if the person becomes confused, faint or very short of breath.

Why primary care matters here

Rebuilding tissue in an open surgical wound takes protein, calories and fluid, at a time when appetite is often poor. Nausea from antibiotics, pain medicine and simply feeling unwell after an operation can cut intake for weeks. A primary care clinician can look at weight, eating and lab results where needed, and suggest practical steps or a dietitian referral. Tobacco is the other large factor. Nicotine narrows small blood vessels and reduces the oxygen reaching the incision, so support for cutting down or quitting is part of wound recovery. Arranging primary care with wound care keeps these conversations from being put off.

Primary care at home in Webster Groves →

Arranging wound follow-up after a surgical site infection in Webster Groves

To arrange wound follow-up after a surgical site infection in Webster Groves, call Gateway at 314-325-0126. Patients, family members and caregivers can call directly, and a referral is not required. We will ask where the patient lives, what has been done for the wound so far and which clinicians are involved. Gateway then confirms whether a partner clinician is available for that address and care setting, requests the relevant records and schedules the visit. At that visit the treating clinician examines the wound and decides on the plan. Our job from then on is the coordination: orders, supplies, follow-up visits and keeping the care team informed.

Families arranging care in Webster Groves should have the address, a phone number, the patient’s regular doctor and a list of current medications on hand when they call 314-325-0126. Mention which entrance has the fewest steps. We coordinate care in nearby Kirkwood, Shrewsbury, Maplewood, Brentwood, Crestwood and Affton as well, so a move to a relative’s home or a facility close by need not mean starting over. Availability is confirmed by location and care setting.

  • County: St. Louis County, Missouri
  • ZIP codes: 63119
  • Nearby hospitals: SSM Health St. Mary's Hospital in Richmond Heights; St. Luke's Des Peres Hospital; Mercy Hospital South (not affiliated with Gateway)
  • Nearby communities: Kirkwood, Shrewsbury, Maplewood, Brentwood, Crestwood, Affton
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

Other conditions and nearby communities

Read the full guide to surgical site infections, or see everything Gateway arranges on the mobile wound care in Webster Groves page.

Common questions

Will my insurance pay for wound follow-up visits in Webster Groves after a surgical site infection?

That depends on your plan, the treating provider and the care that is needed. You can ask us about Medicare, Medicare Advantage, Medicaid and commercial plans, and we help confirm participation and benefits with the treating practice before care starts. Have your insurance card nearby when you call. Decisions about what is paid for rest with your plan, not with Gateway.

What happens when the infection is near a joint replacement, mesh or other hardware?

Infection around implanted material is more serious, because bacteria can cling to surfaces that the body’s defenses and antibiotics reach poorly. The surgical team decides how to manage it, which may involve longer antibiotic treatment, a procedure to wash out the area, or removing or replacing the implant. Wound follow-up in this situation centers on close observation and prompt reporting, so the surgeon hears early about any drainage, opening or new pain.

How long will an infected surgical wound take to close?

No one can give an exact date. It depends on how deep and wide the opened area is, whether the infection is fully controlled, where on the body it sits, and your general health. A better question for the treating clinician is whether the wound is moving in the right direction: smaller measurements, less drainage and healthy tissue at the base from one visit to the next.

Can Gateway keep my regular Webster Groves doctor informed?

Yes. Tell us who your primary care doctor and specialists are when you call. Gateway shares visit records and the treating clinician’s orders with the rest of your care team, and passes questions back when they come up. Your regular doctor stays part of your care. The home visits add to that relationship and do not replace it.

General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.